I had a Marine come into my clinic over the weekend, complaining of a head cold that had lasted for two weeks. His mom came with him. He had a sniffle. The physical exam screamed viral. The rapid strep test was negative. I advised my standard care for viral upper respiratory infections. He was fine with that but looked at me like a whipped puppy while his mom berated me for not prescribing an antibiotic.
Later, a 35 yo woman with chronic supperative otitis media comes in, she's had chunks of her skull removed and can't hear out of her right ear because her eardrum doesn't exist any more, comes in with her dad because she can't drive due to chronic vestibular dysfunction (she's been dizzy since she was 5). She is a portrait of misery, holding back tears during the exam, profusely apologetic for coming in, this is her first infection in 2 years and she's just in absolute despair because she doesn't want more surgery, and begs for the antibiotic only because the antibiotic-steroid combo, in her experience, hurts more and promises she will got to the ER if she gets a headache. Dad says bip the entire time and thanks me for seeing her on short notice on the way out the door.
Has this dichotomy always been present in society and I'm just now at the level where I see it?
For a time, I volunteered for a charity that provided general advice and support, mainly on issues of welfare, money and debt.
The longer I was there, the more obvious it became that most of the people I saw were simply fuck-ups. Although a minority simply had bad luck, most of them were simply unable and unwilling to responsibly manage even the most basic aspects of their lives. In hindsight, this is completely obvious - responsible, resourceful people rarely have need to seek help in running their lives.
Likewise, medics see a completely distorted picture of human health. They see a grossly disproportionate number of people from the minority of the population who are hypochondriacs, or have some form of somatoform disorder, or who chronically abuse their body. Conversely, they only infrequently come into contact with people who don't like to cause a fuss, or people with medical phobias.
There is data to suggest that police officers believe that they are much better than the general population at spotting lies, but are in fact much worse. The best explanation for this is that police officers habitually deal with people who are simply very bad at deceit - skilled criminals are rarely caught, whilst the most incompetent of petty thieves may be arrested several times a week. Officers believe that they know what a lie looks like because they are constantly dealing with people who lie, but in fact the only know what a very bad lie looks like.
Probably the marine is a quiet guy, and his mom (perhaps incorrectly) feels like she has to stand up for him. OTOH the girl seems to be making her case pretty well so the father feels like he doesn't have to add anything to the convo.
At tumor board a few weeks ago a patient presented with a massive, benign head tumor that had been partially resected.
resident presents the case and asks for surgery's opinion
Surgeons: No, it's better to wait until the cavity heals(from the previous surgery) and then evaluate.
Resident: His mother is insisting.
Surgeons: We're not going to do it because his mom insists.
Me: How old is the patient?
Resident: late 30s.
This seems to be the new definition of "hack", just like when somebody "hacks" into your Facebook account and posts rude messages when they visit your home and find your phone or computer unlocked.
I suppose the analogs would be breaking&entering and fraud? I can't imagine this crime in the physical world would land someone with six felony charges though. That's pretty intense.
That's what I thought, but I imagine that it was a matter of averages - that small bump probably placed him on an academic honors list, or made him eligible for a scholarship.
I would say that is closer to hacking the justice system then robbing a bank. Still, any civilized government should offer all of its citizens at least the same rights and benefits as that countries criminals.
The reporter just added up the maximum possible sentence for 6 class-3 felonies. This is SOP in reporting on crimes even though there's no way she'll get that.
The mom is a douche, but the prison sentence possible is nuts. I doubt she'd be up for such a sentence if she'd rammed a stolen truck into the buildings and changed paper records.
Later, a 35 yo woman with chronic supperative otitis media comes in, she's had chunks of her skull removed and can't hear out of her right ear because her eardrum doesn't exist any more, comes in with her dad because she can't drive due to chronic vestibular dysfunction (she's been dizzy since she was 5). She is a portrait of misery, holding back tears during the exam, profusely apologetic for coming in, this is her first infection in 2 years and she's just in absolute despair because she doesn't want more surgery, and begs for the antibiotic only because the antibiotic-steroid combo, in her experience, hurts more and promises she will got to the ER if she gets a headache. Dad says bip the entire time and thanks me for seeing her on short notice on the way out the door.
Has this dichotomy always been present in society and I'm just now at the level where I see it?